A Comparative study of expectant versus active management on maternal and foetal outcome in severe pre-eclampsia patients of 30-34 weeks gestation

Dr. Jeyamani Janaki Baskaran; Dr Anurekha Janaki Periyasamy

Volume : IX, Issue : II, February - 2019

A Comparative study of expectant versus active management on maternal and foetal outcome in severe pre-eclampsia patients of 30-34 weeks gestation

Dr. Jeyamani Janaki Baskaran, Dr Anurekha Janaki Periyasamy

Abstract :

Objective/ purpose of study: Severe preeclampsia is an obstetric dilemma, whether to err on the maternal side or the fetal side, since both of them are in a compromised state. Hence we did this observational study in patients of severe preeclampsia admitted to Obstetrics department of Government Mohan Kumaramangalam Medical college Hospital Salem. Study design: This is an observational study with 100 patients of severe preeclampsia at 30 to 34 weeks gestation. Study was conducted over a year from July 2015 to June 2016. Group I was managed conservatively till the completion of corticosteroids, blood pressure was controlled with rational use of Anti hypertensives. Results: Most patients were primigravida aged 21– 30 years. Mean gestational age at delivery was 32.23 (32.23+ 1.18) weeks in expectant group versus 31.68 (31.68+ 1.02) weeks in active management group. There was no maternal death ; maternal complications did not differ significantly in both the groups. There were 45 (90%) live births in group I while compared to 37 (74%) live births in Group II and also significant excess of mean birth weight 1.67+0.66 kg in group I over group II with 1.33+0.85 kg (P = 0.02); Though in both the groups, majority were VLBW newborns the APGAR score at 5 minutes of birth was slightly better in the expectant management group (group I). Conclusion: Expectant management for severe preeclampsia results in higher birth weight and lesser need for intensive care. But this neonatal benefit must be weighed against the risk of maternal morbidity. Further randomized controlled trials are awaited in future to throw light for practice.